Kava Kava and Fertility: Precautions and Recommendations

Perioperative and Physiological Concerns Relevant to Fertility

Kava has been documented to decrease blood flow to the kidneys, potentially via inhibition of cyclooxygenase, which could theoretically affect other pelvic organs including reproductive structures 1
Kava extracts significantly inhibit multiple cytochrome P450 enzymes, which are clinically significant because many fertility medications and hormonal treatments are metabolized through these same pathways 1
The Society for Perioperative Assessment and Quality Improvement recommends holding kava for 2 weeks before surgery due to potential additive or synergistic effects with anesthetics, benzodiazepines, and opiates 2

Discontinue kava use when planning pregnancy due to potential effects on renal and possibly pelvic blood flow, significant drug interactions that could interfere with fertility medications 1
Hold kava for at least 2 weeks before any fertility procedures to allow clearance of enzyme inhibition effects, and inform fertility specialists about any kava use, as it may affect medication dosing requirements 2, 1
The American Urological Association recommends focusing on proven lifestyle modifications for fertility, including smoking cessation, weight loss if overweight, regular exercise, and dietary improvements 3